Diagnosis

The doctor will ask about your symptoms and medical history. There will be a physical exam as well. The anal area will also be examined, which involves the following:

The doctor will hold the buttocks apart. This will usually turns the anus outward enough for tears to become visible.

If fissures have persisted for three months or more, additional changes may be seen. These changes may include a sentinel tag or "pile," granulation tissue, or white discoloration from scar tissue around the fissure.

If pain permits, the doctor may perform:

Digital rectal exam—doctor inserts a lubricated finger into the anus and feels for lumps or abnormalities

Anoscopy—a tool is inserted in the anus to allow the doctor to examine the anal canal

Fissures usually occur in predictable locations around the anus. If there are multiple cuts, or a cut in an unusual location, the doctor may order additional tests to look for other conditions.